Vitreous cylinders.

Vitreous cylinders, a rarely discussed ophthalmologic entity, were studied in two clinical cases and in five enucleated eyes. The cylinders were found in four cases of ocular toxoplasmosis, one case of vitreous hemorrhage complicating a malignant melanoma, and one case of pars planitis and one of uveitis, both of unknown causes. Results of scanning electron microscopy in one specimen suggested that cylinders are formed by condensation of vitreous collagen fibers. We emphasize the nonspecific nature of this interesting vitreous finding.

Interstitial keratitis caused by American (mucocutaneous) leishmaniasis.

A 58-year-old man with American (mucocutaneous) leishmaniasis had the unusual ocular complication of interstitial keratitis. Although the parasite was not identified, clinical laboratory and histologic findings were compatible with leishmaniasis, and tests ruled out other causes. Ulcerative areas improved after treatment with 1 g of amphotericin B.

Merosin-positive congenital muscular dystrophy in two siblings with cataract and slight mental retardation.

We report on two siblings that have been followed for 14 years, with merosin-positive congenital muscular dystrophy (CMD), cataract, retinitis pigmentosa, dysversion of the optic disc, but no cerebral anomalies, except for microcephaly and slight mental retardation (MR). The younger child had three generalized seizures easily controlled by anticonvulsant therapy. Both children presented hypotonia from birth, delayed psychomotor development, generalized muscular weakness, and atrophy and joint contractures of knees and ankles. The course of the disease, apparently static during the first 10 years of life, became progressive during the second decade with loss of deambulation by the age of 13. Creatine kinase was increased in both children. Bilateral cataract was diagnosed at 6-months of age. In spite of the occurrence of microcephaly, MR was slight and the siblings acquired reading and writing skills after the aged 10. Head magnetic resonance imaging showed normal results in both siblings. The classification of these cases within the broad spectrum of CMD is difficult since most of the known muscle-eye-brain syndromes generally show severe MR and brain anomalies. We consider these cases as corresponding to the rarer syndromes of merosin-positive CMD with associated features such as cataract and MR that were particularly emphasized during the 50th ENMC International Workshop on CMD [Dubowitz V. Workshop report: 50th ENMC International workshop on congenital muscular dystrophy. Neuromusc Disord 1997;7:539-547]. Further genetic, pathological, neuroradiological, and immunocytochemical studies will be necessary for better elucidation of the classification and pathogenesis of CMD.

Leber's congenital amaurosis with associated nephronophthisis.

The authors present a case of a 15-year-old girl with Leber's congenital amaurosis with associated nephronophthisis. The main findings in this case are: congenital blindness; enophthalmos; photophobia; nystagmus; keratoconus; cataracts; pigmentary degeneration in the fundus of both eyes; progressive uremia with absence of hematuria, proteinuria, pyuria, and glycosuria; low urinary density, normal lipidic profile; osteoporosis; absence of edema; polydipsia; polyuria; and a history of consanguinity between her parents. Tranmission of this entity allows an autosomal recessive pattern.

Median cleft face syndrome or frontonasal dysplasia: a case report with associated kidney malformation.

The authors present a case of an 11-month-old girl with the medial cleft face syndrome and the following malformations: ocular hyperterolism, primary telecanthus, cleft nose with absent tip, broad nasal root, complete absence of the left upper lid, and abnormal hair-line implantation in the corresponding frontal region, high arched palate, neurosensorial deafness and agenesia of the right kidney. The authors propose that the eyelid is responsible for the area of hair growth suppression around the eyes. This is the first case report of median cleft face syndrome associated with renal agenesia.

Quantification of ocular inflammation with technetium-99m glucoheptonate.

Histological and morphometric evaluation of ocular inflammation is difficult, particularly when there is extensive ocular involvement with abscess formation and necrosis. A quantitative imaging procedure applicable to humans would be important clinically. To establish such a procedure, turpentine-induced ocular inflammation was obtained by subconjunctival injection in the right eye of 55 rabbits. The left eye was used as control and injected with a volume of saline equal to the volume of turpentine in the right eye. Volumes of turpentine or saline were 0.02, 0.04, 0.06, 0.2 and 0.6 ml, and the rabbits were divided into groups 1-5, according to these volumes. Imaging was performed 48 h after turpentine injection and 6 h after intravenous injection of 10 mCi of technetium-99m glucoheptonate (99mTc-GH). An inflammatory reaction index (IRI), defined as the ratio of counts of the right eye divided by counts of the left eye, was used. IRIs were proportional to the degree of inflammation and allowed the distinction of 3 subgroups: one represented by group 4, one by group 5 and one by groups 1, 2 and 3. This method of quantification of ocular inflammatory processes using 99mTc-GH is original, rapid, non-invasive, reproducible and safe, although unable to differentiate inflammatory processes caused by doses of turpentine which are very small and close to each other. It is conceivable that its application to humans will bring new insight into the ocular inflammatory process and response to therapy.

Diode laser modifications for treatment of choroidal neovascularisation.

The aim of this paper is to describe various diode laser modifications and their use in treating choroidal neovascularisation in age-related macular degeneration. Diode lasers are used to treat selected choroidal neovascular membranes. Alterations in microprocessor connectivity, and parameters such as maximum spot size, light delivery time and coupled Joule meter, were made so that ophthalmic surgeons could specify treatment possibilities. A trimodal (photocoagulation, transpupillary thermotherapy and photodynamic therapy) application laser device coupled to a single light source has been developed. The new diode laser modifications were technically successful. Microprocessor connectivity was obtained, larger spot sizes were achieved, light delivery time could be extended and energy parameters were available at the display.

Oculomicose experimental por aspergillus fumigatus e tratamento com colirio de pimaricina. / Experimental oculomycosis by aspergillus fumigatus and its treatment with primaricin eye drogs

Neste trabalho demonstra-se que o colirio de pimaricina a 5% e eficaz no tratamento de ulceras micoticas causadas por Aspergillus fumigatus, produzidas experimentalmente em corneas de coelhos, quando administrado dentro de 3 horas apos ter ocorrido a inoculacao com os fungos

Contribuicao ao estudo clinico, biomicroscopico e anatomo-patologico dos cilindros vitreos. / Clinical, biomicrospic and anatompathological study of the vitreous cylinders

Esta publicacao estuda aspectos clinicos, biomicroscopicos, microscopicos e patogenicos dos cilindros vitreos em 4 casos clinicos, 3 olhos enucleados cirurgicamente e 2, em neocirurgicas. Estes cilindros sao encontrados em varios processos oculares degenerativos e inflamatorios, a toxoplasma figurado como a etiologia mais comum nos casos do autor.Os cilindros variam de aspecto ate o desaparecimento e nao sao tao raros como a literatura faz crer